I have the same problem. My headache specialist has a slightly different take on the matter. What she wants me to do is worry more about taking my meds AS SOON AS I FEEL A HEADACHE COMING ON. When the pain is still only a 1 or 2 on the scale and worry less about the number of times in a week I take the meds. Very different that most doctors say.
Her thoughts are 1) that rebound happens less often than people think and 2) if the headache is treated sooner then it has less chance of comming back because it has been gotten rid of totally instead of just partially.
This has helped me. For most of my migraines 1 or 2 Treximet and bang goes the headache. I still have issues with those I get around time of month but as long as I have enough Treximet then I am fine, usally.
I must admit that I just had a bad week where I ran out of med and had to make the trip tothe ER so it is not 100% but I have not been in the ER for at least 4 months where I was every month like clock work.
So I recomend trying to take your abortive sooner like when you just think you are getting a migraine or the pain is still below a 3 or 4 and see if that helps.
I do work and am blessed that where I work our sick policy is "if you are sick stay home". No days are docked or anything. Also I can work from home so for now at least I get by. I am lucky that I have finally found a preventative that seems to help and an abortive that works most times, so I get by.
I have had migraines my whole life (40+ years) but have been offically diagnosed for 25 years or so. They run in the family, my Mom has them and my Grandfather had cluster headaches.
I always get migraines during my time of month. This is the one hard and fast rule. A couple of days befoe my flow starts to a couple of days after it ends. Unfortunately I have issues - long flow so this can last up to two weeks of migraine. I have tried so many things we are getting to the point where we are talking hysterectomy. Also most of the common triggers do me in.
There is a form that someone created where you have your doctor fill out some information and you can take that to the ER with you. It sort of helps to not appear to be a "drug seeker" also, if you and your doctor agree on what works he can list a "suggested treatment" and hopefully they would stick to it! (talk about time saver)
The only issue I had with this was ONCE, I had an old snotty doctor who acted like he didnt want another doctor "telling him what to do" on a piece of paper!
(You should be able to click the link on my siggy to get the form)